Coping during a crisis: The impact of COVID-19 on medical students

As spring break started in early March of this year, many of my second-year peers ventured off into various corners of the world, ecstatic for a small reprieve from what is traditionally the most challenging part of medical school: board preparation.

As our weeklong vacation progressed, dread began to seep in. Conferences were canceled; the first guidelines of social distancing were put in place; travel restrictions were established.

In the span of seven days, all semblance of normalcy had been thrown out the window and thus began the shelter-in-place mandate.

Every medical school expects their students to have the ability to adapt; to remain flexible and to persevere during the highs and lows of medical school … but no one could have prepared us for the challenges brought on by COVID-19.

One by one, we were pulled from classrooms, hospitals, and clinics, both for our protection and to reduce the spread of this constantly evolving virus.

Training interrupted

First-year students were in the middle of one of the most important units in anatomy. Second-year students were preparing for their OSCEs (Objective Structured Clinical Examination) and board exams. Third-year students were about to embark on their electives or sub-internships and fourth-year students were anticipating Match Day and graduation.

Just as this virus had disrupted the rest of the community and the world, it had proven the medical school way of life was not immune. As with most of the rest of the world, this unfortunate but necessary change created abrupt social isolation for our medical school, followed by a waxing and waning of uncertainty.

As every single aspect of our medical education has changed, I have struggled.

I’ve cried. I’ve gained and lost weight (got to love the COVID 15). I’ve felt frustrated that all I could do was sit in my living room and watch time escape from my control. I have lost my motivation; I have succumbed to my inner saboteur (I refer to her as Brenda, and she reminds me of all my greatest fears and insecurities). But through it all, I have survived.

‘Sense of dread’

After spending months on Zoom calls, weeks dedicated to board preparation and having only left my apartment to purchase groceries, I had reached a breaking point. I thought that starting rotations would alleviate the sense of dread that had slowly been building within me since March.

To my misfortune, my family medicine rotation was set to be delivered online and through self-guided learning.

While some of my peers were sharing success stories of their first day in clinic, I was trying to accept that I may be asked to spend the “best years of medical school” in my apartment teaching myself what can really only be learned in an exam room.

Yet, my medical school is in an area that used to be a COVID-19 hotspot and at one point we were leading the country new cases per day. I felt ashamed of my anger about remote learning courses when all of us have been asked to make sacrifices.

I have adapted. I decided to take this opportunity to focus on my health, to create a sustainable routine and to make the best of my situation.

I volunteered at COVID testing sites and participated in a countywide survey with my local health department to track mask-wearing. Through outreach and education, we watched the community grow from 35% to 95% of the local population electing to wear masks in public.

I have regained my passion and excitement for medicine. It was there, all along, camouflaged by the very real and very common student-burnout I was experiencing. I am happy to say that I have just completed my first week of internal medicine in a hospital.

Tips for training during a pandemic

But what comes next? Nearly eight months have elapsed since the first shelter-in-place orders, and cases are on the rise across the country as winter approaches. How do we as medical students navigate this new world? Every person’s experience during COVID-19 is unique to them, but I would like to share some things that have helped me cope:

• Improvise, adapt, overcome: What are you missing out on because of this pandemic? Use your ingenuity to create opportunities that can be adapted for the “new normal” we are experiencing.

  During my family medicine rotation, I had more free time than I knew what to do with. I collaborated with fellow classmates on a project that began as a literature review on a subject we were all passionate about. This eventually transformed into a scoping review with a possible publication in the future.

• Acknowledge new changes in assessment of your progress: Previous standards for academic evaluation will differ markedly from what has been established due to COVID. Regularly check in with yourself and assess how you’re doing, what you need, and how you can best succeed as a student.

  Don’t let “pass/fail” lull you into complacency. If you’re in the didactic portion of your education, treat this as board preparation to avoid relearning material as you approach your dedicated board prep time. If you’re on a remote rotation, the time you put in learning medicine while online will only serve you once you transition back into the clinics.

• Routine: Medical school has a reputation for its highly structured environment, so finding a routine that works for you and that is sustainable is crucial for your success. This dawned on me through a period of trial and error. As silly as it sounds, having a consistent bedtime and morning alarm can do wonders for a person.

  Don’t let this pesky virus distract you from your dreams and goals. Wake up, brush your teeth, run three miles, take a shower and get dressed, spend the morning studying, eat a tasty lunch, make time for review and extracurriculars in the afternoon, cuddle with your cat, read a book before bed. Rinse and repeat.

• Give yourself some grace: There will be moments where you may feel like you’re not doing enough given the sudden increase in free time. It’s always okay to make time for yourself, your family, and your social network, or to get involved with a project that you are passionate about.

  There are many ways to continue building your CV during this time, but don’t feel like you must complete them all. Go at your own pace, take care of your well-being first, and try as best as you can to not compare yourself to others.

Into the unknown

Medical students across the country face a multitude of unknowns. I often find myself wondering: How will this continue to affect our curriculum? How long will this “new” normal last? Will this eventually become the “norm?” Will COVID-19 reduce our chances of matching into our desired specialties? What specialties will exist given the economic impact this virus is having on our health care system?

I don’t have the answers to these questions, but what I do know is this: the world needs physicians, now more than ever.

We have been selected to meet these new challenges head on. We have the unique opportunity to learn medicine during a global pandemic. We also have the unique opportunity to change medicine as COVID continues to expose our health care system’s shortcomings. I would argue that this is the perfect time to be studying medicine.

Related reading:

How to navigate virtual residency interviews during COVID-19

How COVID-19 has changed medical education for these trainees